Welcome to NIA HoustonWe are excited to have you. Membership Application Name * First Name Last Name Phone * (###) ### #### Email * Website * http:// Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Company Name * Industry * Specialty * Experience in Professional Classification * Have you ever been a NIA member? Select Yes No Commitments * Are you willing to commit to attend our monthly meeting, arrive on time and stay for the 90 minutes, make referrals when appropriate, and abide by NIA policies, guidelines and code of ethics? Yes No What is your primary goal for Joining NIA? * Networking Coaching If you check "Networking", are you willing to pass 12 referrals over the next year? * Yes No If you checked "Business Coaching" * Please select 3 of 10 options for the areas you wish to develop Finance Marketing Sales Social Media Taxes HR Leadership Legal Business Transition Life Balance Other Do you belong to other networking organizations? * Yes No Terms & Conditions * Terms & Conditions By typing your name you agree to the terms above. * First Name Last Name Date MM DD YYYY ACH Authorization * Bank Name Account Type * Checking Savings Routing Number * Account Number * Choose Your Membership Payment Terms * Monthly $215 + One Time App Fee $200 Annual $2195 + One Time App Fee $200 Thank you for applying to NIA Houston. We have received your application and will be in touch soon to conduct an interview. Please schedule your onboarding call.
